NORTH YORKSHIRE COUNTY COUNCIL

5 May 2021

STATEMENT OF CHAIRMAN OF THE SCRUTINY OF HEALTH COMMITTEE

The Scrutiny of Health Committee has a responsibility to review any matter relating to the planning, provision and operation of health services in the County.  A key part of that responsibility is requiring NHS bodies to consult health scrutiny on proposals for substantial developments or variations to the local health service provision.  One of the powers that the committee has is, in specific circumstances, to refer contested proposals for change to the Secretary of State for Health.

The committee met formally and in public on 12 March 2021 using Microsoft Teams for a live broadcast meeting.  At that meeting, committee members received detailed presentations on: the NHS response to the pandemic, including the progress being made with the vaccination programme; further information on the extent of hospital acquired covid-19 infections, management of waiting lists for routine treatments and elective surgery, and staff sickness absence in the NHS locally; the transfer of hyper acute stroke treatment from Scarborough to York and Hull and the response times and outcomes linked to hyper acute stroke provision; and the development of the Whitby hospital site and the impact that will have upon services provided there.

Outlined below are some areas that the committee has been looking at in-depth.

Scarborough Hospital

The committee continues to scrutinise the changes to hyper acute stroke services.  Those people who exhibit the symptoms of a stroke will bypass Scarborough and be taken directly to York or Hull for specialist treatment.  Prior to the committee meeting on 12 March 2021, the committee was provided with a briefing note by the overview and scrutiny team which gave an overview of research into the ‘golden hour’.  The golden hour and its relevance to the changes to hyper acute stroke services had been debated at some length at previous meetings.  The conclusion of the briefing note stated “There is no specific evidence to suggest a scientific basis to the presumption of a ‘golden hour’ within which hyper acute stroke patients should be treated in order to reduce the potential for death or disability….more targeted care is of greater benefit than assuring a one-hour window of opportunity for treatment.”  This supports the explanations that have been provided to date by NHS commissioners and the experience of patients where services have undergone similar changes, like that at Harrogate Hospital.

The committee received an update on progress with the modernisation of the Scarborough Hospital site and the capital investment of £47 million to develop new urgent, emergency and critical care facilities.  The committee heard that the Full Business Case will be submitted by the end of August 2021.  Once signed off, then then it is anticipated that construction will start in late 2021 or early 2022 and that it will take 2 years.  At this point, then the NHS locally will start a formal programme of consultation and engagement with people who use the hospital, building upon that which they have done to date with key stakeholders.  A further update will be provided at the committee meeting on 17 December 2021.

Re-development of Whtiby Hospital

The committee has scrutinised the plans for the re-development of the Whitby Hospital site for the past five years.  The hospital plays a key role in the delivery of health services, particularly outpatient and diagnostics, in the east of the county and links in with larger hospitals like the James Cook, Scarborough and York.  The construction began on the site on 23 March 2020 just as the first national lockdown commenced.  The work then re-started in June 2020 and should now be completed by 29 June 2021.  A total of £13.1 million has been invested in this work.  The committee members and colleagues who attended from the Scarborough and Whitby and the Thirsk and Malton Area Constituency Committees welcomed the work that has been done and the commitment that has been made to the long term future of the hospital. 

The recent developments at Whitby and Scarborough hospitals demonstrates the key role that the county’s smaller hospitals have to play in the delivery of services and the recognition that not all services can or should be centralised.  I am hopeful that this is something that the Integrated Care Systems and Partnerships will pursue further as they look to deliver health services at a local or neighbourhood level.

NHS pandemic recovery

The committee is undertaking an ongoing review of NHS response to and recovery from the pandemic and what this has meant for the delivery of NHS services.  Members were pleased to hear that some routine elective procedures and some outpatient appointments have been restarted and that fast track appointments have been put in place for cancer assessments and treatment.  Clearly, there is a large backlog of elective surgery and routine treatments, which will pose a real challenge to the NHS, which has been working at full capacity for over a year now.  Commissioners and providers have committed to prioritise all assessments and treatments according to clinical need and to ensure that patients are kept fully informed of what action will be taken.  In addition, work is underway to see what options there are for support in the community for those who are in discomfort and who will be waiting for a long time before they receive the treatment that they need.

The committee also received further information on how primary care services have been working during the pandemic.  Previously, members had raised concerns about difficulties in accessing face-to-face appointments.  Also, that many people who had health needs may have been deterred from seeking the services that they needed during the pandemic, leading to surge in demand once lockdown restrictions area eased.  The committee heard that all GP practices are covid-safe and that the number of appointments (face to face, by telephone or by video) available are rising in number and now at 2/3 of the pre-pandemic level.  The telephone consultations and secure video consultations that are available may better suit some people.

Over the next year, the committee will follow up on the longer term consequences of the pandemic, including: long covid; the increase in prevalence of mental health stress; and the impact upon pre-existing health inequalities.

Committee meeting on 18 June 2021

The next meeting of the committee will be at 10am on 18 June 2021.  At this time, the items for consideration at that meeting are as follows: the development of mental health services in the county, with a focus upon the rectification of the in-patient wards at Roseberry Park, the progress with the Selby Community Hub, the development of enhanced community services and the response of the Tees Esk and Wear NHS FT to a recent CQC report; an update on progress with the implementation of proposed changes to hyper acute stroke services at Scarborough Hospital; the local NHS response to pandemic, including progress with vaccination and the NHS recovery plan; Covid-19 prevalence data; an overview of the NHS White paper and what this means for health services in the county; and a further update on access to NHS dentistry.

Regarding access to NHS dentistry, the committee will receive further information from NHS England about the contractual arrangements that are currently in place and what opportunities there may be for a national review of them and also an update on progress with the procurement of services to fill some of the gaps in provision that have emerged recently.

Mid Cycle Briefing on 23 April 2021

The next meeting of the Mid Cycle Briefing will be at 10am on 23 April 2021.  This meeting will focus on developing lines of enquiry for matters that are to be brought to the formal meetings of the committee and developing the committee work programme.  At this time, the items that will be considered at the meeting are: the regional review of hyper acute stroke services; the Tees Esk and Wear Valleys NHS FT response to the recent CQC inspection; Local Plans and the use of s.106 funding to support the development of health services in a housing growth area; and the York and Scarborough Teaching Hospitals NHS FT response to January 2020 CQC inspection of Scarborough Hospital.

COUNTY COUNCILLOR JOHN ENNIS

Chairman of the Scrutiny of Health Committee

19 April 2021